Comparison of MRI/US Fusion Targeted Biopsy and Systematic Biopsy in Biopsy-Naïve Prostate Patients with Elevated Prostate-Specific Antigen: A Diagnostic Study

Chen Huang; Yuhua Huang; Jinxian Pu; Qilin Xi; Xuedong Wei; Feng Qiu; Ximing Wang; Xiaojun Zhao; Linchuan Guo; Jianquan Hou

doi:10.2147/CMAR.S350701

Comparison of MRI/US Fusion Targeted Biopsy and Systematic Biopsy in Biopsy-Naïve Prostate Patients with Elevated Prostate-Specific Antigen: A Diagnostic Study

Cancer Manag Res. 2022 Apr 8:14:1395-1407. doi: 10.2147/CMAR.S350701. eCollection 2022.

Authors

Chen Huang^#¹, Yuhua Huang^#¹, Jinxian Pu¹, Qilin Xi¹, Xuedong Wei¹, Feng Qiu¹, Ximing Wang², Xiaojun Zhao¹, Linchuan Guo³, Jianquan Hou¹

Affiliations

¹ Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.
² Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.
³ Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: This study aimed to compare the detection rate of prostate cancer (PCa) between targeted biopsy and systematic biopsy.

Patients and methods: A total of 671 patients who underwent both targeted biopsy and systematic biopsy were included in this study. The stratified analysis was conducted based on Prostate Imaging Reporting and Data System (PIRADS) scores, region of interest load (ROI-load).

Results: There was no statistical difference in the detection rate of PCa patients between systematic biopsy and targeted biopsy (44.41% vs 45.6%, P>0.05), while the detection rate of targeted biopsy in clinically significant PCa (csPCa) patients was slightly higher than that of systematic biopsy (40.83% vs 38.15%, P=0.033). Stratified analysis indicated that targeted biopsy was more advantageous in csPCa patients with PIRADS score ≥ 4 and ROI-load > 5%. The comparison of diagnostic sensitivity of systematic biopsy and targeted biopsy demonstrated that targeted biopsy was more sensitive than systematic biopsy to diagnose PCa (Z=2.110, P=0.035) at ROI-load ≤ 5%. In addition, ROI-load may be a better targeted biopsy indicator than ROI diameter for the diagnosis of PCa (Z=2.168, P=0.030).

Conclusion: MRI/US fusion targeted biopsy may be more suitable for PCa detection than systematic biopsy in patients with low ROI-load.

Keywords: detection; multiparametric-MRI; prostate cancer; targeted biopsy.

Grants and funding

This work was supported by two grants from the Social Development Programs of Science and Technology Commission Foundation of Jiangsu Province of China (No. BE2020654 and No.BE2020655) and a grant from the General Program of Jiangsu Health Commission (No. H2019040) and a grant from National Key R&D Program of China (No.2017YFC0114303). We thank all colleagues for their support during the data collection and the preparation of this manuscript.